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By John Schieszer
Medical Minutes 

Insulin pills, virtual reality and the paleo diet

Medical Minutes


Virtually reality may help prevent falls

Researchers have found that combining virtual reality and treadmill training may be an ideal way to help prevent falls in older adults. The researchers report in the journal The Lancet that this type of intervention, which combines the physical and cognitive aspects of walking, could potentially be used in gyms, rehabilitation centers or nursing homes to improve safe walking and prevent falls in older adults. They said it may also help adults with disorders that affect movement such as Parkinson’s disease.

The researchers analyzed data from 282 participants from five clinical sites in Belgium, Israel, Italy, the Netherlands and the UK between 2013 and 2015. All subjects were between the ages 60 and 90. Nearly half had Parkinson’s disease and some had mild cognitive impairment.  Some were assigned to treadmill training with virtual reality and some were assigned to treadmill training alone.

The virtual reality component consisted of a camera that captured the movement of participants’ feet and projected it onto a screen in front of the treadmill, so that participants could ‘see’ their feet walking on the screen in real time. The game-like simulation was designed to reduce the risk of falls in older adults by including real life challenges such as avoiding and stepping over obstacles like puddles or hurdles, and navigating pathways.

On average, participants in each group took part in 16 training sessions over six weeks, with each session lasting about 45 minutes. Fall rates were recorded in the six months following the end of training. Prior to training, participants in the treadmill-only group had an average of 10.7 falls per six months, and participants in the treadmill plus virtual reality group averaged 11.9 falls per six months.

During the six months after training, the incidence rate of falls decreased in both groups.  However, the decrease was significantly higher in the treadmill plus virtual reality group, resulting in a 42 percent reduction.

“Falls in older people often occur because of tripping and poor obstacle negotiation while walking. Falls often start a vicious cycle, which has many important negative health consequences. Older people’s ability to negotiate obstacles can be impaired because of age-related decline in cognitive abilities like motor planning, divided attention, executive control, and judgement, yet current interventions for falls in older adults typically focus on improving muscle strength, balance and gait,” said study author Dr Anat Mirelman, who is with the study of Movement, Cognition and Mobility (CMCM), Neurology Institute at the Tel Aviv Sourasky Medical Center, Tel Aviv, Israel.


Insulin pills may become a reality

Millions of Americans with diabetes every day have to inject themselves with insulin to manage their blood sugar levels. However, less painful alternatives are emerging. Scientists are developing a new way of administering the medicine orally with tiny vesicles that can deliver insulin where it needs to go without a shot.

Researchers at Niagara University in New York presenting their initial findings at the 252nd National Meeting & Exposition of the American Chemical Society (ACS). They have developed encapsulated insulin. The biggest obstacle to delivering insulin orally is ushering it through the stomach intact. Proteins such as insulin are no match for the harsh, highly acidic environment of the stomach. They degrade before they get a chance to move into the intestines and on to the bloodstream where they’re needed.

Some efforts have been made to overcome or sidestep this barrier. One approach packages insulin inside a protective polymer coating to shield the protein from stomach acids and is being tested in clinical trials. Another company developed and marketed inhalable insulin. However, despite rave reviews from some patients, this has not proved to be preferable.

Researchers at Niagara University have successfully encapsulated insulin. The novel vesicles are made of naturally occurring lipid molecules, which are normal building blocks of fats. The investigators are using simple lipid esters to make vesicles with the drug molecules inside. Computer modeling showed that once the lipids are assembled into spheres, they form neutral particles resistant to attack from stomach acids.

The researchers have demonstrated success in animal studies. Next, they plan to further optimize their various formulations and begin human trials.


Paleo diet scrutinized

The popular Paleo diet is based on eating foods thought to be available to our ancestors during the Paleolithic era, before the advent of dairy or processed grains. Findings from a small study suggest that people who followed the Paleo diet for only eight weeks experienced positive effects on heart health. Preliminary findings, which were presented at the American Physiological Society’s Inflammation, Immunity and Cardiovascular Disease conference, showed short-term dietary changes from a traditional Western pattern of eating to foods promoted in the Paleo diet may improve health.

“Very few studies have examined the Paleo diet in seemingly healthy participants, despite the prevalence of this dietary practice in health and fitness enthusiasts,” said study author Chad Dolan, a graduate student researcher at University of Houston Laboratory of Integrative Physiology, Houston, Texas.

The researchers asked eight healthy people who normally consumed a traditional Western diet high in processed foods to switch to the Paleo diet, which consists of minimally processed foods for eight weeks. The participants received a sample Paleo diet menu and recipe guide, as well as initial counseling on how to incorporate the Paleo diet into their everyday lives. They were told to eat as much food as they wanted while following the diet.

The researchers found that the study participants experienced a 35 percent increase in levels of interlukin-10 (IL-10), a signaling molecule secreted by immune cells. A low IL-10 value can predict increased heart attack risk in people who also have high levels of inflammation. Scientist think that high IL-10 levels may counteract inflammation, providing a protective effect for blood vessels.

Although the researchers have not yet analyzed inflammation levels in the study participants, the increase in IL-10 could suggest a lower risk for cardiovascular disease after following the Paleo diet. The researchers also observed changes in other biomarkers of inflammation.

Even though the study was not designed to promote weight loss, the participants did drop some pounds during the eight-week trial. Compared with what they regularly ate before the study, participants reported consuming around 22 percent fewer calories and 44 percent fewer grams of carbohydrates on the Paleo diet.

The researchers caution that the current findings are preliminary. They plan to conduct a study with a greater number of people who follow the diet for a longer period of time to analyze how it affects various risk factors for cardiovascular and coronary artery disease, cellular immune function and metabolic health.

John Schieszer is an award-winning national journalist and radio and podcast broadcaster of The Medical Minute. He can be reached at

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John Schieszer is an award-winning national journalist and radio and podcast broadcaster of The Medical Minute.

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